Herpes zoster ophthalmicus in children.

Herpes zoster ophthalmicus, first described fully by Jonathan Hutchinson in 1866, is very rare in children, being predominantly an adult affection (Doggart, 1933; Bjork, 1950; Duke-Elder, 1952). Koch (1939), in reporting a case in a child of 51 years of age, states that only one other child, aged 12, developed zoster ophthalmicus at the Mayo Clinic before 1938. In a fairly exhaustive analysis of the literature by Poulsen (1955) only 17 cases had been reported in children, three of whom had the disease within the first year of life. Poulsen adds his own contribution, that of a boy of 15 months. Several standard text books (Mitchell Nelson, 1954; Cecil and Loeb, 1951; Price, 1956) make little or no mention of herpes zoster ophthalmicus in infants and children. Edgerton (1945), in a detailed analysis of herpes zoster ophthalmicus, found about 2,250 cases in the world literature. The average age of these cases was 43 years. He could only find 44 cases under 13 years of age, but did not attempt to differentiate between the epidemic or symptomatic forms. He does, however, state that in the vast majority of cases of ophthalmic zoster, the disease was secondary or symptomatic. In view of the great deal of evidence which has accumulated recently linking the virus of herpes with that of chickenpox (Bokay, 1909; Brain, 1933; Amies 1934; Weller, 1953; Simpson, 1954; Blank and Rake, 1955) it is surprising to find so few authenticated cases of herpes zoster in children, while chickenpox is such a common and highly infectious exanthema. Chickenpox has its maximum incidence in childhood, whereas herpes is more commonly observed from the ages of 20 to 65 years. Edgerton (1945), on the other hand, quotes Evans and Fox (1905) as saying that herpes zoster ophthalmicus was common in the young. They state that one half of their patients were under 14 years of age. Cases of ophthalmic zoster in children have been reported by other authors as well, but few detailed descriptions can be found in